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Elif Nur Özbay Flashcards

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1
Q

Endemic:

A

a disease of low morbidity, constantly present in a certain
region, or among a particular group, characteristic to it, showing no or
little change by time, e.g., sleeping sickness in an African country

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2
Q

Epidemic:

A

a significant increase in an infection in a certain region or a
population at the same time than is previously common at that time

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3
Q

Pandemic:

A

an epidemic distributed over wide geographical areas
(worldwide), e.g., COVID-19

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4
Q

Common manifestations of infections diseases :

A

Fever,loss of weight,Headache, nausea, weakness, loss of appetite, joint and muscle pain
Complaints about urination ,diarrhea,skin rash

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5
Q

Maculopapular rash:

A

measles, rubella, dengue, rickettsia spotted fevers, primary HIV disease

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6
Q

Vesicular rash :

A

chickenpox, **herpes zoster, disseminated herpes simplex

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7
Q

Haemorrhagic rash :

A

meningococcaemia, viral haemorrhagic fevers, disseminated intravascular coagulation
**in the zona zoster

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8
Q

**Congenital infections:

A

infections acquired in utero or during delivery;
TORCH, toxoplasmosis, rubella, cytomegalovirus, syphilis, HIV disease,
coxsackie virus

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9
Q

Butcher,veterinarians,animal breeder:

A

Brucellosis
Q fever
Anthrax
Orf

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10
Q

Fisherman, butcher, veterinarian

A

Erysipeloid

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11
Q

Hunter

A

Tularemia
Rabies

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12
Q

Sewage worker

A

A hepatitis
Leptospirosis

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13
Q

Forest worker

A

STDs and AIDS

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14
Q

Laboratory facilities

A

AIDS
Hepatitis
Brucellosis
Salmonellosis
Tularemia
Tuberculosis

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15
Q

Routes of transmission of infections

A

Orofaecal route
Direct contact:
Sexual transmission:
Vertical transmission:
Air-borne transmission:
Droplet contact:
Vector-borne transmission:
Skin penetration or contact:
Animal

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16
Q

Rational use of antibiotics

A

• Microbiology guides therapy
wherever possible • Indications should be evidence-
based • Narrowest spectrum required • Dosage appropriate to the site
and type of infection • Minimise duration of therapy • Ensure monotherapy in most
situations

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17
Q

Me chanism of Action of antibiotics:

A

• Inhibition of Cell Wall
Synthesis • Disruption of Cell
Membrane • Inhibition of Protein
Synthesis • Interference with
Metabolic Processes

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18
Q

**Using Appropriate Antibiotic

A

• Prevent the both development of the resistance to endogenous flora
and nosocomial infection • Improve patient care (The best efficacy / less toxicity) • If you have multiple options, choosing of the cheapest and most
effective as a pharmacodynamic.

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19
Q

Factors affecting selection of antibiotics

A

-properties of infections:the location and characteristics of the infection
-properties of patients:age,allergies,underlying diseases,pregnancy,before used and now using antibiotics
-properties of antibiotics:spectrum,mechanisms,interval of dose,route of administration,timing,drug interactions,side effects,cost

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20
Q

Pe ripheral nerves: pain, numbness, tingling

A

Aminoglycosides

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21
Q

Inner ear (hearing & balance)

A

Gentamicin /Vancomycin

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22
Q

Growing bones & teeth

A

Tetra c yc lines

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23
Q

Liver

A

Rifampicin / Isoniazid

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24
Q

Kidney

A

Gentamicin /Vancomycin /Cotrimoxazole

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25
Skin (photosensitivity)
Tetra c yc lines, Quinolones
26
Hypo and hyper glicemia) and tendon rupture
Quinolones
27
Bone marrow
Chloramphenicol /Cotrimoxazole
28
**Ideal Antibiotic Using
• Correct antibiotic • Best way (IV,IM,PO) • Effective dosage • Optimal timing • Appropriate period • After correct diagnosis
29
**Using Combine Antibiotics
They offer a broad spectrum effect with synergistic interaction • Treatment of mixed infections • Synergistic effect against P. Aeruginosa • Prevent the development of resistance • Reducing the toxicity of antibiotics ------------------------------------- • Expanding the antimicrobial spectrum • Polymicrobial infection • Serious infections in neutropenic patients • Prevent the development of bacterial resistance • Synergistic effect
30
When two antimicrobial are combined invitro they may demonsrate one of the three types of interactions against a given organism
-additive -synergism -antagonism
31
**Synergy
The influence of drugs combination, these drugs is the sum of the effects that Synergy result from using only a single one • 1 + 1 > 2
32
Un desirable Effects of Combination Antibiotic
• Antogonizm • Colonisation of resistance microorganism and superinfection • Toxicity and increasing side effect • Increasing cost
33
Which factor we pay attention for prescribing antibiotics
• Age • Physiological functions • Pregnancy • Site and severity of infection • Allergy • Antibiotic factors • Pharmacokinetic/pharmacodynamic (PK/PD) profile
34
Adverse reactions to penicillin
-IgE antibody anaphylaxis early urticarial <72 (penicillin G) -cytotoxic antibody hemolytic anemia (penicillin G) -antigen-antibody complex disease (penicillin G)
35
Adverse reactions to aminoglycoside
-Nephrotoxicity -ototoxocity -cochlear -vestibular
36
**UTI is more common in women than men**why:
• short urethra • It can easily infect the urethra from the perianal region. • Sexual contact • Adhesion to the epithelium
37
-The urinary system is sterile -normal flora of the urethra includes lactobacilli and staphylococci -Anaerobic microorganisms rarely cause UTIs. -Fungal agents, especially Candida species, cause infections in catheterized patients receiving antibiotic therapy. -Among viral agents, adenoviruses cause hemorrhagic cystitis in pediatric patients and allogeneic bone marrow recipients. -The kidney is frequently affected in patients with Staphylococcus aureus bacteremia or endocarditis. -In older patients, infections are mostly asymptomatic.
38
**What is the most common cause of acute infection of UTI?
Escherichia coli
39
..............causes infection in sexually active young women?
S. saprophyticus
40
Lower urinary tract infection
-Urethritis,cystitis
41
Upper urinary tract infection
Pyelonephritis Perinephritic abscess
42
Protection mechanisms Of UTI
(1) Elimination of bacteria from the bladder by voiding (2) Antibacterial properties of urine and its constituent compounds (3) Defense mechanisms of the bladder mucosa (4) Acid environment in the vagina in women (5) Prostate secretion in men
43
Risk Factors Of UTI
• Obstruction in urinary flow: tumor, stenosis, stone • Catheterization, urethral dilatation, cystoscopy • Renal tx
44
CYSTITIS
• Frequent urination • Urgent urge to urinate • Burning while urinating and after urination • Suprapubic pain • Bloody and/or cloudy urine
45
BACTERIURIA
name given to the presence of bacteria in the urine-possibility of infected urine in the bladder
46
SIGNIFICANT BACTERIURIA
Presence of at least 100,000 bacteria per ml
47
ASYMPTOMATIC BACTERIURIA
the presence of significant bacteriuria without symptoms in the patient
48
Complicated UTIs
Includes UTIs occurring in the presence of urologic abnormalities and UTIs in pregnancy.
49
RELAPS
Recurrence of bacteriuria with the same causative organism despite treatment
50
REINFECTION
recurrence of infection with a different microorganism - a new infection
51
UROSEPSIS
Development of sepsis syndrome due to UTI
52
**HOW TO TAKE A URINE SAMPLE?
• Midstream urine is collected. • The most suitable sample is the first urine in the morning. -in women first the vaginal entrance is cleaned with gauze impregnated with water-sf , antiseptics can lead to low bacterial counts -clean urine has a clear appearance,cloudy appearance in infection. -bad odor may indicate infection
53
**However, this test is positive in Enterobacteriaceae (E.coli, Klebsiella, Proteus etc.) members, it may be negative in the presence of some factors.
• Acinetobacter • Pseudomonas • Staphylococcus saprophyticus • Enterococcus • Even if the urine is very dilute, it may be negative.
54
Normal urine pH
5.5-6.5
55
Culture is essential in complicated or recurrent UTI.
56
**Sterile pyuria agents:
• Chlamydia • Mycoplasma • Ureoplasma • Trichomonas • Gonococci • Candida • Tbc • Stone • Foreign body • Glomerulonephritis
57
N.gonorrhoeae urethritis
• Incubation periodis short (4 days) • It is of sudden onset. • Dysuria • Purulent discharge • Dysuria and discharge coexistence • Spontaneous discharge and hyperemia in the urethral meatus
58
C.trachomatis, U.urealyticum, M.genitalium, H.simplex, Adenovirus, T.vaginalis (Urethritis)
• Incubation periodis variable (2-35 days), usually long. • It starts within days. • Dysuria • Mucopurulent or serous discharge • There is either discharge or dysuria. • Spontaneous discharge and hyperemia in the urethral meatus
59
Nosocomial Infections
Nosocomial infections also referred to as healthcare-associated infection* (HAI), are infection(s) acquired during the process of receiving health care that was not present during the time of admission to the hospital. ** Infections may be caused by a microorganism acquired from another person in the hospital (cross-infection)  Infections may be caused by the patient’s own flora (endogenous infection).  Some organisms may be acquired from an inanimate object or substances recently contaminated from another human source (environmental infection).
60
How do we classify? Types of Healthcare-Associated Infections
 Central line-associated bloodstream infections (CLABSI)  Catheter-associated urinary tract infections (CAUTI)  Surgical site infections (SSI)  Ventilator-associated pneumonia (VAP)
61
Important patient factors influencing acquisition of infection include
Age,immune status,chronic disease
62
.........are the most common pathogens for HAIs, followed by fungi and viruses. .............is the least
Bacteria (most) Parasitic (least)
63
Bacteria of nosocomial inf
 Common Gram-positive organisms include coagulase-negative Staphylococci, Staphylococcus aureus, Streptococcus species, and Enterococcus species (e.g. faecalis, faecium).  Methicillin-resistant S. aureus (MRSA) transmit through direct contact, open wounds and contaminated hands. It causes sepsis, pneumonia and SSI by travelling from organs or bloodstream. It is highly resistant towards antibiotics called beta-lactams.  Acinetobacter spp.  Bacteroides fragilis is a commensal bacteria found in intestinal tract and colon. It causes infections when combined with other bacteria  Clostridium difficile cause inflammation of colon leading to antibiotic-associated diarrhea and colitis, mainly due to elimination of beneficial bacteria with that of pathogenic.  C. difficile is transmitted from an infected patient to others through healthcare staff via improper cleansed hands  Enterobacteriaceae (carbapenem- resistance) cause infections if travel to other body parts from gut; where it is usually found. Enterobacteriaceae constitute Klebsiella species and Escherichia coli. Their high resistance towards carbapenem causes the defense against them more difficult. Gram-negative organism:Klebsiella pneumoniae and Klebsiella oxytoca, Escherichia coli, Proteus mirabilis, and Enterobacter species; Pseudomonas aeruginosa, Acinetobacter baumanii…
64
What are the resistant bacteria that can cause hospital infection?
 Methicillin-resistant Staphylococcus aureus (MRSA),  Vancomycin-resistant Staphylococcus aureus (VRSA)*Not much in Turkye  Vancomycin-resistant Enterococcus (VRE)* We have in our Hospital  Enterobacteriaceae and Acinetobacter species, and multi-drug resistant Pseudomonas aeruginosa* These are also very common in our hospitals
65
Which hospital infection is most common?
C.difficile
66
Viruses oh nosocomial inf
 Healthcare-acquired hepatitis B and C and human deficiency virus (HIV) has been implicated in unsafe needle practices. (needle injury)  Other reported viral pathogens include rhinovirus, cytomegalovirus, herpes simplex virus, rotavirus, and influenza. (transmitted by respiratory or fecal-oral transmission)
67
Fungi
C. albicans, C. parapsilosis, C.glabrata
68
Pathogens associated with healthcare-associated infection (HAI) may have different routes of transmission.
- The most common route of transmission is through contact, whereby the organisms are transmitted by direct or indirect contact.  Common microorganisms that may be transmitted through contact are multidrug- resistant bacteria (such as MRSA, ESBL-producing Gram-negative organisms, VRE), C. difficile, and rotavirus. - Droplet transmission may occur when microorganisms are transmitted from the respiratory tract by large droplets (greater than 5 microns) and travel less than 3 feet  Examples of infectious pathogens that are transmitted via the droplet route include influenza, Bordetella pertussis, and Neisseria meningitidis - Airborne transmission involves the transmission of organisms from the respiratory tract by small droplets (less than 5 microns) that travel long distances  Chickenpox virus, tuberculosis, measles, and the novel SARS-COV-2 virus may be transmitted through the airborne route
69
**Risk factors for Central Line-Associated Blood Stream Infection
Tu axa has
70
What are the risk factors of CAUTI
 The most critical risk factor for CAUTI is the duration of catheterization.  Operative or insertion protocol, such as nonadherence to aseptic techniques, is another modifiable risk factor.  Patient characteristics that predispose to increased risk are female sex, paraplegia, cerebrovascular disease, older age, diabetes mellitus, history of UTI in the preceding year, and recent antibiotic use within 90 days
71
Procedure-related risk factors include  Duration of surgery  Wound type (clean/dirty)  Hypothermia and hypovolemia during surgery  Hypoxemia,  The urgency of surgery  More than one intervention/surgery  Necessity for blood transfusion  Type of prosthesis implanted
The most critical risk factor is the duration of operation due to the time that the tissue is exposed to the environment leading to an increased chance of contamination
72
**Hospital-acquired pneumonia (HAP)
pneumonia that develops after 48 hours of admission.
73
**Ventilator-associated pneumonia (VAP)
develops after 48 hours of endotracheal intubation.
74
***When we should wash our hands?
 Before touching a patient  Before clean/aseptic procedures  After body fluid exposure/risk  After touching a patient  After touching patient surroundings

Infection (3 decks)

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